Fri Apr 26 2024

112 articles - From Friday Apr 19 2024 to Friday Apr 26 2024

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Guidelines

Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…

Aliment Pharmacol Ther

Editorial: Is it time to include oral vancomycin in therapeutic guidelines for primary sclerosing cholangitis-associated inflammatory bowel disease?

Pubmed   Journal   ReadQx 

Endoscopy

American Society for Gastrointestinal Endoscopy-European Society of Gastrointestinal Endoscopy guideline on primary endoscopic bariatric and metabolic therapies for adults with obesity.

The guideline suggests the use of EBMTs plus lifestyle modification in patients with a BMI of ≥30 kg/m 2 , or with a BMI of 27.0-29.9 kg/m 2 with at least 1 obesity-related comorbidity. Furthermore, it suggests the utilization of intragastric balloons and devices for endoscopic gastric remodeling (EGR) in conjunction with lifestyle modification for this patient population.

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Gastroenterology

AGA Clinical Practice Update on Pain Management in Inflammatory Bowel Disease: Commentary.

This expert commentary incorporates important as well as recently published studies in this field, and it reflects the experiences of the authors. Formal ratings regarding the quality of evidence or strength of the presented considerations were not included because systematic reviews were not performed.

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Gastrointest Endosc

American Society for Gastrointestinal Endoscopy-European Society of Gastrointestinal Endoscopy guideline on primary endoscopic bariatric and metabolic therapies for adults with obesity.

The guideline suggests the use of EBMTs plus lifestyle modification in patients with a BMI of ≥ 30 kg/m 2 , or with a BMI of 27.0-29.9 kg/m 2 with at least 1 obesity-related comorbidity. Furthermore, it suggests the utilization of intragastric balloons and devices for endoscopic gastric remodeling (EGR) in conjunction with lifestyle modification for this patient population.

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Consensus statements on the current landscape of artificial intelligence applications in endoscopy, addressing roadblocks, and advancing artificial intelligence in gastroenterology.

The consensus process led by the ASGE AI Task Force and experts from various disciplines has shed light on the potential of AI in endoscopy and gastroenterology. AI-based algorithms have shown promise in augmenting endoscopist performance, redefining quality metrics, optimizing workflows, and aiding in predictive modeling and diagnosis. However, challenges remain in evaluating AI algorithms, ensuring transparency and interpretability, addressing governance and data procurement, determining payment models, defining relevant clinical outcomes, and fostering collaboration between stakeholders. Addressing these challenges while maintaining a balanced perspective is crucial for the meaningful advancement of AI in gastroenterology.

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Meta-analysis

meta-analyses and systematic reviews

Aliment Pharmacol Ther

Meta-analysis: Persistence of advanced therapies in the treatment of inflammatory bowel disease.

This meta-analysis highlights the superior persistence of ustekinumab and vedolizumab over TNFi, and offers valuable insights for clinicians navigating the challenging landscape of UC and CD therapeutic choices.

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Am J Gastroenterol

Quantified Metrics of Gastric Emptying Delay by GLP-1 Agonists: A Systematic Review and Meta-Analysis with Insights for Periprocedural Management.

While a gastric emptying delay of ∼36 minutes is quantifiable on GLP-1 RA medications, it is of limited magnitude relative to standard periprocedural fasting periods. There were no substantial differences in gastric emptying on modalities reflective of liquid emptying (AAT), particularly at time points relevant to periprocedural care.

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Endoscopy

Palliative procedures for malignant gastric outlet obstruction: A network meta-analysis.

PGJ and EGE are recommended for malignant GOO. PGJ could be the alternative choice in centers with limited resources or cases unsuitable for EGE.

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Gastrointest Endosc

EUS- versus ERCP-guided biliary drainage for malignant biliary obstruction: A systematic review and meta-analysis of randomized controlled trials.

EUS-BD and ERCP-BD had similar efficacy and safety as the initial approach for MBO. However, EUS-BD had a significantly lower risk of reintervention, post-procedure pancreatitis, tumor in/overgrowth, and reduced hospital stay.

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Hepatology

Ultrasound-based steatosis grading system using 2D-attenuation imaging: an individual patient data meta-analysis with external validation.

ATI is a reliable, non-invasive marker of steatosis. This validated ATI-based steatosis grading system could be valuable in assessing MASLD patients.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Aliment Pharmacol Ther

Diagnostic yield from symptomatic lower gastrointestinal endoscopy in the UK: A British Society of Gastroenterology analysis using data from the National Endoscopy Database.

Most colonoscopies were performed on patients with low-risk symptoms, where cancer risk was similar to the general population. Cancer and large polyp yield was highest in elderly patients with rectal bleeding or anaemia, although still fell short of FIT-based screening yields.

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Dietary factors and patterns in relation to risk of later-onset ulcerative colitis in Chinese: A prospective study of 0.5 million people.

The findings highlight the importance of evaluating dietary factors and patterns in the primary prevention of later-onset UC in Chinese adults.

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Hepatic inflammation and fibrosis are profiles related to mid-term mortality in biopsy-proven MASLD: A multicenter study in Japan.

In patients with biopsy-proven MASLD, the prevalence of MASH and advanced fibrosis was approximately 65% and 20%, respectively. The leading cause of mortality was liver-related events. Hepatic inflammation and fibrosis were significant factors influencing mid-term mortality. These findings highlight the importance of targeting inflammation and fibrosis in the management of patients with MASLD.

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Long-term clinical outcomes in steatotic liver disease and incidence of liver-related events, cardiovascular events and all-cause mortality.

The new consensus nomenclature can be used to stratify the risk of complications and prognosis. The nomenclature is beneficial for risk stratification and identifying new mechanisms for disease-specific therapeutic implications.

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Magnetic resonance enterography findings 46 weeks after initiation of biological therapy predict long-term adverse outcomes in Crohn's disease.

MRE findings at week-46 after initiating biological therapy can predict long-term adverse outcomes in CD. Therapeutic intervention may be required in patients with persistence of severe inflammatory lesions, CD-associated complications, or creeping fat.

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Randomised clinical trial: First-line infliximab biosimilar is cost-effective compared to conventional treatment in paediatric Crohn's disease.

First-line infliximab treatment resulted in higher odds of being in clinical remission without being more expensive, making it the dominant strategy over conventional treatment in the first 2 years after diagnosis in children with moderate-to-severe Crohn's disease.

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Recent steroid use and the relapse risk in ulcerative colitis patients with endoscopic healing.

Even for patients with UC who achieved EH, the risk of relapse remains high following recent steroid therapy. Physicians need to consider the duration since last steroid use to stratify the relapse risk in UC patients with EH.

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Steatotic liver disease-associated all-cause/cause-specific mortality in the United States.

SLD, especially MASLD and MetALD, is associated with increased all-cause mortality among adults in the US. Given this significant association between SLD or subtype of SLD (MASLD and MetALD) and all-cause mortality, adopting the proposed SLD criteria may help identify a sub-group of individuals with SLD who are at an increased risk for all-cause mortality.

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Am J Gastroenterol

"Reducing Eosinophil Counts in Eosinophilic Esophagitis in Children Is Associated with Reduction in Later Stricture Development".

In this cohort study with > 10 years of follow up, children with EoE with a period of histologic disease control and diagnosed at younger ages were less likely to develop esophageal strictures. While this suggests histologic remission is associated with reduction of remodeling complications, additional prospective data with long-term follow up is needed.

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Adjunctive Use of WATS-3D in Symptomatic GERD Patients Increases Detection of Barrett's Esophagus and Dysplasia.

The addition of WATS-3D to FB in GERD patients being screened for BE resulted in confirmation of BE in an additional ⅕ th of patients. Furthermore, dysplasia diagnoses approximately doubled.

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Artificial Intelligence for Quantifying Cumulative Small Bowel Disease Severity on CT-Enterography in Crohn's Disease.

Automated cumulative ileal injury scores show promise for improving prediction of outcomes in small bowel CD. Beyond replicating expert judgement, spatial enterography analysis can augment the personalization of bowel assessment in CD.

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Improved adenoma detection rate using a novel colonoscopic distal attachment: a multicenter randomized controlled trial.

EAC significantly increased ADR and APC compared with SC, particularly for adenomas < 10 mm, non-pedunculated adenomas, and adenomas in the transverse and left colon.

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Laryngeal Recalibration Therapy Improves Laryngopharyngeal Symptoms in Patients with Suspected Laryngopharyngeal Reflux Disease.

85% of patients with chronic laryngopharyngeal symptoms referred for GERD evaluation that underwent LRT experienced laryngeal symptom response. Rates of symptom response were maintained across patients with or without proven GERD as well as patients with or without concomitant esophageal reflux symptoms. SLP directed LRT is an effective approach to incorporate into multi-disciplinary management of chronic laryngopharyngeal symptoms/laryngopharyngeal reflux disease.

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Transoral Outlet Reduction: Expert Tips, Tricks, and Troubleshooting.

As endoscopic bariatric therapies are increasingly incorporated into the multidisciplinary management of obesity, it is crucial to have a standardized, evidence-based framework for their implementation. Here, based on the available literature and the authors' combined experience of over 1,000 TORe procedures, we present our approach to patient selection, procedural technique, troubleshooting, and patient aftercare unique to TORe.

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Visceral adipose tissue reduction measured by deep neural network architecture improved reflux esophagitis endoscopic grade.

Visceral obesity is strongly associated with RE. VAT volume reduction was prospectively associated with improvement in RE endoscopic grade dose-dependently. Visceral obesity is a potential target for RE treatment.

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Clin Gastroenterol Hepatol

Centrally Distributed Adiposity as a Modifiable Risk Factor for Fecal Incontinence: U.S. Population-Based Analysis.

WHtR was independently associated with increased odds of FI in this nationally representative sample of US adults, whereas BMI was not consistently correlated. This suggests bowel continence may depend more on how body mass is distributed.

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Endosc Int Open

Audit of hemostatic clip use after colorectal polyp resection in an academic endoscopy unit.

Audits of clip use in an endoscopy practice can reveal surprising findings, including high and variable rates of unnecessary use after cold resection. Audit can potentially reduce unnecessary costs, carbon emissions, and plastic waste.

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Deep learning and capsule endoscopy: Automatic multi-brand and multi-device panendoscopic detection of vascular lesions.

This is the first proof-of-concept artificial intelligence deep learning model developed for pan-endoscopic automatic detection of vascular lesions during CE. The diagnostic performance of this CNN in multi-brand devices addresses an essential issue of technological interoperability, allowing it to be replicated in multiple technological settings.

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Novel treatment with double scope technique for disconnected pancreatic duct syndrome with external pancreatic fistula.

Two-scope-guided tractogastrostomy for treatment of external pancreatic fistula due to disconnected pancreatic duct syndrome is a feasible technique and can be further evaluated.

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Quantification of interstitial cells of Cajal and fibrosis during gastric per-oral endoscopic myotomy and its association with clinical outcomes.

The degree of fibrosis may be related to pyloric dysfunction and clinical response to G-POEM. Additional studies are needed to confirm these results.

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Endoscopy

Environmental impact of small-bowel capsule endoscopy.

The GHG emission of SBCE is mainly determined by patient travelling. The capsule device itself has a comparably low carbon footprint. Considering capsule components disposal is illegal, retrieval of the capsule seems crucial but increasing device-related emissions.

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Training in optical diagnosis in community hospitals is associated with improved recognition and treatment of T1 CRC: a prospective multicenter intervention study (OPTICAL II).

Training in optical recognition of T1CRCs in community hospitals was associated with an increase in sensitivity for T1CRCs. Recognition led to a higher rate of en bloc local excision, resulting in higher R0-resection rates. This may be an important step towards more organ-preserving strategies.

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Gastroenterology

Clinical presentation and spectrum of gluten symptomatology in celiac disease.

Biomarkers like interleukin-2 that are highly sensitive and specific for celiac disease highlight a role for gluten-specific T cells in acute gluten symptomatology. A mechanistic understanding of symptoms will inform approaches to better measure and effectively treat them.

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Phosphatidylinositol 4-kinase III alpha governs cytoskeletal organization for invasiveness of liver cancer cells.

PI4KIIIα regulates cytoskeleton organization via PIK3C2γ/Akt2/paxillin-cofilin to favor migration and invasion of liver cancer cells. These findings provide mechanistic insight into the contribution of PI4KIIIα and HCV to progression of liver cancer and identify promising targets for therapeutic intervention.

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Gastrointest Endosc

COMPUTER-AIDED DIAGNOSIS IMPROVES CHARACTERIZATION OF BARRETT'S NEOPLASIA BY GENERAL ENDOSCOPISTS.

CADx assistance significantly increased characterization performance of BE neoplasia by general endoscopists to the level of expert endoscopists. The use of this CADx system may thereby improve daily Barrett surveillance.

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Detection of residual stones by peroral direct cholangioscopy in patients with intrahepatic stones after hepaticojejunostomy: A prospective study (with video).

PDCS is a safe and effective procedure for complete stone removal in patients with IHBD stones after HJ.

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Validation of Artificial Intelligence-based Bowel Preparation Assessment in Screening Colonoscopy.

In unqualified-AI patients, the >5mm AMR was significantly higher than in qualified-AI patients (35.71% vs 13.19%, p=0.0056, OR 0.2734, 95% CI 0.1139, 0.6565), as were the AMR (50.89% vs 20.79%, p 5mm AMR, provided key evidence for implementing AI in guiding the bowel re-cleansing, potentially standardizing the future colonoscopy screening; ClincialTrials. gov, NCT05145712.

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Gut

Hypoxia-inducible factor-1α mediates reflux-induced epithelial-mesenchymal plasticity in Barrett's oesophagus patients.

In BO patients, reflux oesophagitis induces EMP changes associated with increased HIF-1α signalling in Barrett's metaplasia. In Barrett's cells, ABS trigger EMP via HIF-1α signalling. Thus, HIF-1α appears to play a key role in mediating reflux-induced EMP that might contribute to cancer in BO.

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Impact of age, comorbidities and relevant changes on surveillance strategy of intraductal papillary mucinous neoplasms: a competing risk analysis.

Although it is not uncommon the occurrence of changes considered by current guidelines as relevant during surveillance of low risk BD-IPMNs, malignancy rate is low and survival is significantly affected by competing patients' age and comorbidities. IPMN surveillance strategy should be tailored based on these features and modulated over time.

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Hepatology

A genome-wide association study identified PTPN2 as a population-specific susceptibility gene locus for primary biliary cholangitis.

PTPN2, a novel susceptibility gene for PBC in the Japanese population, may be involved in the pathogenesis of PBC via an insufficient negative feedback loop caused by the PTPN2 risk allele of rs2292758 in IFN signaling. This suggests that PTPN2 could be a potential molecular target for PBC treatment.

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Alcohol-associated liver disease - global epidemiology.

Addressing the growing ALD concern requires robust public health initiatives, heightened awareness, refined diagnostic techniques, and comprehensive epidemiological studies. These measures are vital to tackle the increasing prevalence of ALD and mitigate its extensive impact on individuals and healthcare systems.

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JFH1-based Core-NS2 genotype variants of HCV with genetic stability in vivo and in vitro: Important tools in evaluation of virus neutralization.

These mouse-selected HCV recombinants enable triage of new vaccine-relevant antibodies in vitro and further allow characterization of protection from infection in vivo using identical viruses in human-liver chimeric mice. As such, these viruses will serve as important resources in testing novel antibodies and can thus guide strategies to develop an efficient protective vaccine against HCV infection.

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PNPLA3 rs738409, age, diabetes, sex, and advanced fibrosis jointly contribute to the risk of major adverse liver outcomes in metabolic-associated steatotic liver disease.

The deleterious effects of PNPLA3 rs738409 on the risk of MALO are significantly worsened by advanced fibrosis, age, T2DM, and sex.

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Vascular damage and excessive proliferation compromise liver function after extended hepatectomy in mice.

In summary, SFSS arises from an imbalance and desynchronized interplay between functional regeneration and vascular restructuring. To improve survival following SFSS-hepatectomy, it is essential to adopt a two-pronged strategy aimed at preserving the function of proliferating parenchymal cells and simultaneously attenuating vascular damage.

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J Hepatol

Comparison of non-contrast abbreviated MRI and ultrasound as surveillance modalities for HCC.

Annual NC-AMRI showed a marginally higher sensitivity than biannual US for HCC detection in high-risk patients. The DY of annual NC-AMRI was significantly higher than that of biannual US, without increasing the FRR. Alternating US and NC-AMRI at 6-month intervals could be an optimal surveillance strategy for high-risk patients. Impact and implications Current guidelines permit the use of magnetic resonance imaging (MRI) as a surveillance tool for hepatocellular carcinoma (HCC) in patients in whom ultrasonography (US) is inadequate. However, the specific indications, imaging sequences, and surveillance intervals for MRI surveillance remain unclear. In our study, we found that annual non-contrast (NC)-abbreviated MRI (AMRI) exhibited marginally higher sensitivity and significantly better diagnostic yield than biannual US in high-risk patients for HCC. Adopting alternating US and NC-AMRI at 6-month intervals demonstrated significantly improved sensitivity compared to biannual US, making it a potentially optimal surveillance strategy for high-risk patients. Clinical trial number ClinicalTrials.gov Identifier NCT02551250.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Aliment Pharmacol Ther

Editorial: Adequate protein intake is more crucial than the profile of amino acids intake for sarcopenia prevention during the earlier stages of liver cirrhosis.

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Editorial: Are changes in quantitative biliary metrics the first sign of progression in primary sclerosing cholangitis?

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Editorial: Are glucagon-like peptide-1 receptor agonists the functional cure for patients with metabolic dysfunction-associated cirrhosis?

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Editorial: Can dietary gluten restriction improve hepatic steatosis?

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Editorial: Crystalising the burden of steatotic liver disease.

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Editorial: Enriching our understanding of MASLD through representation of under-reported populations.

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Editorial: Exploring the influence of diet on later-onset ulcerative colitis-Are eggs and spicy foods the key factors in Asia?

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Editorial: Foretelling the future-Emerging role of magnetic resonance enterography as a prognostic tool in Crohn's disease.

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Editorial: High qHBsAg-is it a good or bad signal?

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Editorial: Mortality in immune-mediated inflammatory diseases during early adulthood.

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Editorial: Novel insights into the prognostic relevance of high-dose PPI treatment in patients with cirrhosis.

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Editorial: Peering through the fog-New tools to assess neurocognitive symptoms in coeliac disease.

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Editorial: Redefining liver health-Personalised approach to assessment of serum ALT in clinical practice.

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Editorial: Sequencing rescue therapy for acute severe ulcerative colitis-Ready for revision?

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Editorial: Terlipressin and MDRO colonisation in cirrhosis-Is there a causal link?

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Clin Gastroenterol Hepatol

Blue Notes.

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Endoscopy

ESGE Young Endoscopists - keeping an EYE on the future.

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Endoscopy E-Videos - recently published.

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Gastroenterology

Changing fate: how EGFRs "pit" cell vs cell in the stomach.

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Presentation of the Julius M. Friedenwald Medal to M. Bishr Omary.

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Gastrointest Endosc

Improving colonoscopy quality: growing evidence to support adenomas per colonoscopy as a standard quality indicator.

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Phase analysis: a novel and useful application of artificial intelligence in endoscopy.

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Miscellaneous

misc publications eg case reports, tools of the trade, images of the month, etc…

Am J Gastroenterol

Multidisciplinary Collaborative Team for Screening of Autoimmune Gastritis.

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Clin Gastroenterol Hepatol

En bloc endoscopic submucosal dissection of a large laterally spreading tumor involving the papilla.

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Longitudinal Follow-up of Fib-4 in Patients at Risk of MASLD Receiving Low-dose Methotrexate Treatment.

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Endosc Int Open

Computer-aided detection for colorectal neoplasia in randomized and non-randomized studies.

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Endoscopy

Combined percutaneous-endoscopic puncture rendezvous technique for biliary-enteric anastomotic occlusion after pancreaticoduodenectomy.

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Difficult management of pancreatic pseudocyst drainage in a 4-year-old child.

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Endoscopic sutured purse-string resection: a novel technique for resection of large gastric subepithelial lesions.

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Endoscopic ultrasound-directed transgastric ERCP for disconnected pancreatic duct syndrome: finding the edge to bridge the gap.

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Gastric endoscopic submucosal dissection in Western countries: current and future perspective.

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Kill two birds with one stone: Flexible cholangioscopy for treatment of common bile duct stone and identification of suspicious gallbladder wall thickening.

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Outcomes of endoscopic submucosal dissection of early gastric cancer neoplasia in the West and change in the absolute indications.

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Pancreatic-portal vein fistula in acute pancreatitis successfully treated with endoscopic approach.

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Peroral cholangioscopy-guided lithotripsy using a novel thin cholangioscope under balloon enteroscopy for Roux-en-Y anastomosis.

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Pull-back myotomy to prevent mucosal injury during peroral endoscopic myotomy for jackhammer esophagus.

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The running suture with clip and string technique after colonic endoscopic submucosal dissection.

Pubmed   Journal   ReadQx   PMC

Gastroenterology

A Rare Case Mimicking Congenital Hepatic Fibrosis.

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An Alcohol-Associated Rash.

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An Unusual Cause of Cat Scratch Colon.

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Clearance of gut mucosal SARS-CoV-2 antigens and post-acute COVID-19 after two years in patients with inflammatory bowel disease.

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Severe Acute Hepatitis of Unknown Etiology in Children: New Virus or Immune Dysregulation.

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Unlocking the potential of fecal virome transplants (FVT): modulating the gut-brain axis in stress-related disorders.

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Gastrointest Endosc

Prevention of inadvertent injury of diaphragm during posterior peroral endoscopic myotomy for achalasia cardia.

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Gut

Mast cells and histamine in cholangiocarcinoma: exploring overlooked avenues for enhanced patient management.

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Hepatology

Clonal hematopoiesis of indeterminate potential and risk of hepatocellular carcinoma: New kids on the block.

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Understanding advanced cystic fibrosis liver disease through genetic variation: Where do the pathways lead and how much further must we go?

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J Hepatol

A different picture on liver biopsy.

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Animal hepacivirus models for hepatitis C virus immune responses and pathology.

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From the Editor's Desk...

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Letters&Replies

Letters to the editors and authors’ replies

Aliment Pharmacol Ther

Editorial: Crystalising the burden of steatotic liver disease-Authors' reply.

Pubmed   Journal   ReadQx 

Editorial: Sequencing rescue therapy for acute severe ulcerative colitis-Ready for revision? Authors' reply.

Pubmed   Journal   ReadQx 

Letter: Association of persistently high HBsAg levels during HBeAg-seropositive stage and hepatocellular carcinoma risk in chronic hepatitis B patients-Authors' reply.

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Letter: Association of persistently high HBsAg levels during HBeAg-seropositive stage and hepatocellular carcinoma risk in chronic hepatitis B patients.

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Letter: Bif195 for aspirin-induced gastric mucosal damage - More to do in further research. Authors' reply.

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Letter: Bif195 for aspirin-induced gastric mucosal damage-More to do in further research.

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Letter: Presence of progression or absence of response? Alternative trial designs for immunotherapy of advanced hepatocellular carcinoma.

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Letter: Risks of proton pump inhibitor treatment in cirrhotic patients.

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Letter: Shorter duration of intravenous terlipressin for variceal bleeding in patients with cirrhosis-A promising find.

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Letter: Shorter duration of intravenous terlipressin for variceal bleeding in patients with cirrhosis-A promising find. Author's reply.

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Letter: The enigma of angiotensin receptor blocker-associated enteropathy.

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Clin Gastroenterol Hepatol

Complexity of trials on pain management in acute pancreatitis: an ongoing challenge.

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Gastroenterology

GLP1 Receptor Agonists and Post-Endoscopic Aspiration Pneumonia: What Plays a Role in Clinical Practice?

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Sessile Serrated Lesions Pursuit: FITness and Benchmark.

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Gastrointest Endosc

Does indomethacin reduce the risk of thromboembolic events in patients undergoing ERCP?

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Endoscopic techniques to reduce recurrence after EMR of large nonpedunculated colorectal polyps.

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The superiority of blue-light imaging and narrow-band imaging over white-light imaging in the detection of proximal colonic lesions.

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